What is self-harm?

Self-harm is when someone hurts themselves intentionally (on purpose).

Most people who self-harm aren't attempting suicide. This is known as non-suicidal self-injury. There are many reasons why someone may self-harm. It can be a way to express or control distressing thoughts or feelings. It may arise from feelings of guilt, or a need to be punished. Some people who self-harm do so to distract from other things that are causing them pain.

Self-harm often causes more damage to your health and safety than you may have intended.

If you self-harm, you are not alone. Many Australians struggle with self-harm. There is support available.

What signs suggest someone may be self-harming?

Self-harm may go unnoticed by others. Many people who self-harm do so in private. They might harm areas of their body that they can cover. They may not ask for help.

Self-harm may include behaviours such as:

• cutting, burning or hitting yourself
• participating in risky behaviour
• disordered eating
• abuse of drugs or alcohol

Signs that someone may be self-harming can include:

• changes in mood
• being secretive
• avoiding situations where they would have to expose their arms or legs
• unexplained injuries, or strange excuses for injuries
• withdrawing from relationships and usual activities

Why might someone self-harm?

There are many reasons people self-harm. It is a sign of personal distress and the reason for each person is different.

Most people who self-harm aren't attempting to take their life. This is known as non-suicidal self-injury.

Some reasons people self-harm are:

• To manage or control distressing thoughts, feelings or memories.
• As self-punishment, if they feel guilt, shame, or think they are to blame for something.
• As a distraction from other things that may be causing emotional pain.
• To express painful emotions.
• To communicate a need for support.

Some people who self-harm may only do so once, whereas others self-harm frequently and for many years.

For most people, the feeling of relief after self-harming is only short term. This can result in a desire to self-harm again. People can get trapped in a cycle of self-harm. Self-harming behaviour can occur in anyone at any age. Some very young people self-harm.

Some people are more vulnerable to self-harming, such as people who:

• live with mental health concerns
• have experienced physical, emotional or sexual abuse
• have a family history of self-harm

Some triggers for self-harm may include:

• bullying
• loneliness
• abuse and domestic violence
• school or work problems
• relationship problems
• low self-esteem
• difficulty identifying or expressing distress in words

When should I seek help for self-harm?

If you self-harm, it may be difficult to ask for help. It's important to find someone who can understand and support you.

One place to start is to build a support network. Try to surround yourself with people who:

• you feel comfortable with
• you can talk to
• will listen without judgement

If you have a friend or a family member you can trust, reach out to them to help you. They can help you to make an appointment with a doctor or other professional.

Your doctor can work with you to develop a treatment plan. For further help, they can also refer you to trained mental health professionals such as:

• counsellors
• psychologists
• mental health nurses

Your healthcare professionals can help diagnose any underlying mental health issues you may have. They can also help you access support for managing self-harm.

Seeking help early can reduce the damage caused by self-harm and decrease your risk of self-harming again.

How can I support someone I care about who is self-harming?

If you think your or another person's safety is at risk, call triple zero (000) immediately.

If you think someone you care for is self-harming, it is important that you:

• let them know they can talk to you
• offer support
• encourage them to get professional help

If they talk to you about their self-harm or mental health, you can:

• take the time to listen to them with curiosity
• validate their concerns and emotions
• do not judge their experiences

If they are open to suggestions, you can suggest healthier coping strategies.

If you are concerned for someone's welfare and want to tell a healthcare professional, it's important to tell the person first. Reassure them that:

• you have their best interests in mind
• you care about them
• your intentions are to help keep them safe

It's important to be there for the person that you care about. But, it can be overwhelming. You can seek support and advice for your own mental health from a healthcare professional or helpline. Doing this can also help set a positive example for your loved one.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is self-harm treated?

There are different approaches to treating self-harm.

Techniques that work as alternatives and distractions from self-harm can help you in the short term. You might also need to get professional help for the underlying issues.

Psychotherapy

Psychological therapies can help you understand why you self-harm. They can also give you tools and techniques to help you cope with challenging thoughts and feelings. You can discuss with your therapist how to manage situations that add to your distress.

Some psychological therapies used for self-harm are:

• cognitive behaviour therapy
• dialectical behavioural therapy
• ACT (Acceptance and Commitment Therapy)
• problem solving therapy

Healthy distractions and coping mechanisms

If you are struggling with emotions that may lead you to self-harm, try distracting yourself with an activity you enjoy. This may include:

• reading
• art
• journaling
• listening to music
• going for a walk

If you still feel the need to self-harm, try putting your energy into a different activity that will not cause injury, such as:

• holding ice cubes in your hands
• wearing a rubber band on your wrist and snapping it
• drawing on your skin instead of injuring yourself
• punching a pillow

Deep breathing and relaxation exercises may also help manage stress and painful emotions. This can help you avoid self-harm.

You may want to make a list of alternative activities on a piece of paper or in your phone. This way you have it when you need it.

Complications of self-harming behaviour

Self-harming behaviour can have very serious complications. If you cause more damage than you meant to, self-harm can lead to serious physical harm or accidental suicide.

People who repeatedly self-harm may become suicidal or feel hopeless.

Substance abuse as a form of self-harm can make you more vulnerable to taking an accidental overdose.

If you self-harm by repeatedly cutting or burning, it can scar your skin. People who self-harm may find it difficult to care for their cuts or scars. There are ways to help fade scars or cover them. You can ask your doctor or pharmacist for advice.

Resources and support

It's important you reach out if you need to talk to someone. Support and information are available from these organisations:

• Medicare Mental Health (previously Head to Health) — for advice and to get connected to local mental health services, you can call 1800 595 212. Check the operating times.
• SANE Australia — you can phone the helpline on 1800 187 263
• Lifeline — call 13 11 14 for 24-hour crisis support or chat online
• Suicide Call Back Service — phone 1300 659 467 or chat online
• Kids Helpline — WebChat or call 1800 551 800
• Beyond Blue — call a counsellor on 1300 22 4636
• MensLine Australia — phone and online counselling, call 1300 78 99 78
• Headspace — the National Youth Mental Health Foundation

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Support for carers

If you are caring for someone who self-harms or who has a mental health issue, here are some organisations that can help you.

Mental Health Carers Australia provides specialist mental health support to families, carers and friends.

Carer Gateway provides services, support and counselling for carers. You can call them on 1800 422 737.

Carers Australia provides many services for carers including counselling, advocacy, education and training.

If you would like to learn how to support people struggling with the challenges of self-harm and mental illness, consider doing a mental health first aid course.

Support for Aboriginal and Torres Strait Islander people

If you are, or if you know an Aboriginal and Torres Strait Islander person who self-harms, there are resources available.

Orygen have guidelines available on supporting young Aboriginal people who self-harm.

You can also read about self-harm and suicide on the Australian Indigenous HealthInfoNet website.

Resources for Culturally and Linguistically Diverse people

If you speak a language other than English, here are some resources available in multiple languages:

• The In case of emergency (if you experience suicidal thoughts) fact sheet and the self-care plan fact sheet by This Way Up.
• The Orygen #chatsafe guide is a young person's guide to communicating safely online about self-harm.
• The body positivity webpage from Healthy Horizons.